Lower Strength Alcohol Products—A Realist Review-Based Road Map for European Policy Making
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Implementation
3.1.1. What Is the Extent of the Production of Lower Strength Products?
Grey Literature
Academic Publications
3.1.2. To What Extent Are Consumers Buying and Drinking Lower Strength Alcohol Products?
Grey Literature
Academic Publications
3.1.3. What Are the Currently Implemented Policies Relevant for Lower Strength Alcohol Products?
Grey Literature
Academic Publications
3.2. Context
3.2.1. Who Buys and Drinks Lower Strength Alcohol Products and Why?
Grey Literature
Academic Publications
3.2.2. What Factors Influence the Production of Lower Strength Products?
Grey Literature
Academic Publications
3.2.3. Policies That Promote Lower Strength Products
Grey Literature
Academic Publications
3.3. Mechanisms of Impact
3.3.1. Do Current Consumers Substitute Higher Strength with Lower Strength Products? Grey Literature
Academic Publications
3.3.2. Does Buying and Drinking Lower Strength Products Act as a Gateway to Buying and Drinking Higher Strength Products?
Grey Literature
Academic Publications
3.3.3. Is There Additional and Alibi Marketing Due to the Introduction of Lower Strength Alcohol Products?
Grey Literature
Academic Publications
3.3.4. Is There Policy Interference Following the Introduction of Lower Strength Products?
Grey Literature
Academic Publications
3.4. Outcomes
3.4.1. Does Substitution Recue Alcohol Consumption?
Grey Literature
Academic Publications
3.4.2. Does Substitution Improve Health?
Grey Literature
Academic Publications
4. Discussion
5. Conclusions and Road Map for Alcohol Policy
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
References
- Pohl, K.; Moodley, P.; Dhanda, A. Alcohol’s Impact on the Gut and Liver. Nutrients 2021, 13, 3170. [Google Scholar] [CrossRef] [PubMed]
- Morojele, N.; Shenoi, S.; Shuper, P.; Braithwaite, R.; Rehm, J. Alcohol Use and the Risk of Communicable Diseases. Nutrients 2021, 13, 3317. [Google Scholar] [CrossRef] [PubMed]
- Popova, S.; Dozet, D.; Shield, K.; Rehm, J.; Burd, L. Alcohol’s Impact on the Fetus. Nutrients 2021, 13, 3452. [Google Scholar] [CrossRef] [PubMed]
- Chikritzhs, T.; Livingston, M. Alcohol and the Risk of Injury. Nutrients 2021, 13, 2777. [Google Scholar] [CrossRef]
- Rehm, J.; Rovira, P.; Llamosas-Falcón, L.; Shield, K. Dose–Response Relationships between Levels of Alcohol Use and Risks of Mortality or Disease, for All People, by Age, Sex, and Specific Risk Factors. Nutrients 2021, 13, 2652. [Google Scholar] [CrossRef]
- Okaru, A.; Lachenmeier, D. Margin of Exposure Analyses and Overall Toxic Effects of Alcohol with Special Consideration of Carcinogenicity. Nutrients 2021, 13, 3785. [Google Scholar] [CrossRef]
- Rumgay, H.; Murphy, N.; Ferrari, P.; Soerjomataram, I. Alcohol and Cancer: Epidemiology and Biological Mechanisms. Nutrients 2021, 13, 3173. [Google Scholar] [CrossRef]
- IARC. Alcohol drinking. IARC Monogr. Eval. Carcinog. Risks Hum. 1988, 44, 1–378. [Google Scholar]
- IARC. Alcohol consumption and ethyl carbamate. IARC Monogr. Eval. Carcinog. Risks Hum. 2010, 96, 1–1428. [Google Scholar]
- International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans Volume 100E. Personal Habits and Indoor Combustion. 2012. Available online: https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-TheIdentification-Of-Carcinogenic-Hazards-To-Humans/PersonalHabits-And-Indoor-Combustions-2012 (accessed on 9 November 2020).
- WHO Regional Office for Europe. Alcohol Consumption, Harm and Policy Responses in 30 European Countries. Available online: https://www.euro.who.int/en/health-topics/disease-prevention/alcohol-use/publications/2019/status-report-on-alcohol-consumption,-harm-and-policy-responses-in-30-european-countries-2019 (accessed on 30 June 2022).
- Łyszczarz, B. Production Losses Associated with Alcohol-Attributable Mortality in the European Union. Int. J. Environ. Res. Public Health 2019, 16, 3536. [Google Scholar] [CrossRef]
- Barrio, P.; Reynolds, J.; García-Altés, A.; Gual, A.; Anderson, P. Social cost of illegal drugs, alcohol and tobacco in the European Union: A systematic review. Drug Alcohol Rev. 2017, 36, 578–588. [Google Scholar] [CrossRef] [PubMed]
- UN Sustainable Development Goals. Available online: https://sdgs.un.org/goals (accessed on 30 June 2022).
- World Health Organization. Noncommunicable Diseases Global Monitoring Framework: Indicator Definitions and Specifications. 2014. Available online: http://www.who.int/nmh/ncd-tools/indicators/GMF_Indicator_Definitions_FinalNOV2014.pdf?ua=1 (accessed on 30 June 2022).
- Wood, A.; Kaptoge, S.; Butterworth, A.; Paul, D.; Burgess, S.; Sweeting, M.; Bell, S.; Astle, W.; Willeit, P.; Bolton, T.; et al. Risk thresholds for alcohol consumption: Combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies. Lancet 2018, 391, 1513–1523. [Google Scholar] [CrossRef] [Green Version]
- World Health Organization. The SAFER Technical Package: Five Areas of Intervention at National and Subnational Level; World Health Organization: Geneva, Switzerland, 2019; Available online: https://www.who.int/publications/i/item/the-safer-technical-package (accessed on 30 June 2022).
- OECD. Preventing Harmful Alcohol Use, OECD Health Policy Studies; OECD Publishing: Paris, France, 2021. [Google Scholar] [CrossRef]
- Political Declaration of the Third High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases. Available online: https://apps.who.int/gb/ebwha/pdf_files/EB150/B150_7Add1-en.pdf (accessed on 30 June 2022).
- Pawson, R.; Greenhalgh, T.; Harvey, G.; Walshe, K. Realist review—A new method of systematic review designed for complex policy interventions. J. Health Serv. Res. Policy 2005, 10 (Suppl. 1), 21–34. [Google Scholar] [CrossRef] [PubMed]
- Rycroft-Malone, J.; McCormack, B.; Hutchinson, A.M.; DeCorby, K.; Bucknall, T.K.; Kent, B.; Schultz, A.; Snelgrove-Clarke, E.; Stetler, C.B.; Titler, M.; et al. Realist synthesis: Illustrating the method for implementation research. Implement. Sci. 2012, 7, 33. [Google Scholar] [CrossRef] [PubMed]
- Rehm, J.; Lachenmeier, D.W.; Jané-Llopis, E.; Imtiaz, S.; Anderson, P. On the evidence base of reducing ethanol content in beverages to reduce the harmful use of alcohol. Lancet Gastroenterol. Hepatol. 2016, 1, 78–83. [Google Scholar] [CrossRef]
- Prodcom. Statistics on the Production of Manufactured Goods—PRODCOM User Guide; Eurostat: Luxembourg, 2021; p. 16. Available online: https://ec.europa.eu/eurostat/documents/120432/4433294/europroms-user-guide.pdf (accessed on 30 June 2022).
- Moore, G.; Audrey, S.; Barker, M.; Bond, L.; Bonell, C.; Hardeman, W.; Moore, L.; O’Cathain, A.; Tinati, T.; Wight, D.; et al. Process Evaluation of Complex Interventions UK Medical Research Council (MRC) Guidance. 2014. Available online: https://mrc.ukri.org/documents/pdf/mrc-phsrn-process-evaluation-guidance-final/ (accessed on 30 June 2022).
- Anderson, P.; Kokole, D.; Llopis, E. Production, Consumption, and Potential Public Health Impact of Low- and No-Alcohol Products: Results of a Scoping Review. Nutrients 2021, 13, 3153. [Google Scholar] [CrossRef]
- Adams, J.; Hillier-Brown, F.C.; Moore, H.J.; Lake, A.A.; Araujo-Soares, V.; White, M.; Summerbell, C. Searching and synthesising ‘grey literature’ and ‘grey information’ in public health: Critical reflections on three case studies. Syst. Rev. 2016, 5, 164. [Google Scholar] [CrossRef]
- No- and Low-Alcohol in Key Global Markets Reaches Almost US$10 Billion in Value. Available online: https://www.theiwsr.com/no-and-low-alcohol-in-key-global-markets-reaches-almost-us10-billion-in-value/ (accessed on 30 June 2022).
- Kokole, D.; Llopis, E.J.; Anderson, P. Non-alcoholic beer in the European Union and UK: Availability and apparent consumption. Drug Alcohol Rev. 2021, 41, 550–560. [Google Scholar] [CrossRef]
- Anderson, P.; Llopis, E.J.; O’Donnell, A.; Manthey, J.; Rehm, J. Impact of low and no alcohol beers on purchases of alcohol: Interrupted time series analysis of British household shopping data, 2015–2018. BMJ Open 2020, 10, e036371. [Google Scholar] [CrossRef]
- Anderson, P.; O’Donnell, A.; Llopis, E.J.; Kaner, E. The impact of lower-strength alcohol products on alcohol purchases: ARIMA analyses based on 4 million purchases by 69,803 households, 2015–2019. J. Public Health 2022, in press. [Google Scholar] [CrossRef]
- Anderson, P.; Kokole, D.; Llopis, E.J. The impact of lower-strength alcohol products on alcohol purchases: ARIMA analyses based on 1.29 million purchases by 18,954 Spanish households, 2nd quarter 2017 to end of 1st quarter 2022. Nutrients 2022, 14, 3412. [Google Scholar]
- Advertising Code for Alcohol Free and Low Alcohol Beer. Available online: https://www.reclamecode.nl/nrc/advertising-code-for-alcohol-free-and-low-alcohol-beer-rvaab/?lang=en (accessed on 14 March 2021).
- Noel, J.K.; Babor, T.F.; Robaina, K. Industry self-regulation of alcohol marketing: A systematic review of content and exposure research. Addiction 2017, 112 (Suppl. 1), 28–50. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Holmes, J.; Angus, C. Alcohol deaths rise sharply in England and Wales. BMJ 2021, 372, n607. [Google Scholar] [CrossRef]
- UK Government. Advancing our Health: Prevention in the 2020s—Consultation Document. 2019. Available online: https://www.gov.uk/government/consultations/advancing-our-health-prevention-in-the-2020s/advancing-our-health-prevention-in-the-2020s-consultation-document (accessed on 30 August 2021).
- Low Alcohol Descriptors Guidance. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/763840/low-alcohol-descriptors-guidance.pdf (accessed on 30 June 2022).
- Council Directive 92/83/EEC of 19 October 1992 on the Harmonization of the Structures of Excise Duties on Alcohol and Alcoholic Beverages. Available online: https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=celex:31992L0083 (accessed on 30 June 2022).
- Council Directive (EU) 2020/1151 of 29 July 2020 Amending Directive 92/83/EEC on the Harmonization of the Structures of Excise Duties on Alcohol and Alcoholic Beverages. Available online: https://eur-lex.europa.eu/eli/dir/2020/1151/oj (accessed on 30 June 2022).
- Regulation (EU) 2021/2117 of the European Parliament and of the Council. Available online: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:32021R2117 (accessed on 30 June 2022).
- Pomarici, E.; Sardone, R. EU wine policy in the framework of the CAP: Post-2020 challenges. Agric. Food Econ. 2020, 8, 17. [Google Scholar] [CrossRef]
- Regulation (EU) No 1169/2011 of the European Parliament and of the Council. Available online: https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=celex%3A32011R1169 (accessed on 30 June 2022).
- Regulation (EC) No 1924/2006 of the European Parliament and of the Council of 20 December 2006 on Nutrition and Health Claims Made on Foods. Available online: https://eur-lex.europa.eu/legal-content/en/ALL/?uri=CELEX%3A32006R1924 (accessed on 30 June 2022).
- Council Directive 92/84/EEC of 19 October 1992 on the Approximation of the Rates of Excise Duty on Alcohol and Alcoholic Beverages. Available online: https://eur-lex.europa.eu/eli/dir/1992/84/oj (accessed on 30 June 2022).
- How Much Alcohol-Free Does the Netherlands Drink? Available online: https://expertisecentrumalcohol.trimbos.nl/items/details/aanbod-en-cijfers-gebruik-alcoholvrije-dranken (accessed on 14 March 2021).
- VuMA Touchpoints. Available online: https://www.vuma.de/vuma-praxis/zugang-zur-vuma (accessed on 14 March 2021).
- Corfe, S.; Hyde, R.; Shepherd, J. Alcohol-Free and Low-Strength Drinks Understanding Their Role in Reducing Alcohol-Related Harms. Available online: https://www.smf.co.uk/publications/no-low-alcohol-harms/ (accessed on 30 August 2021).
- Nederlandse Brouwers. Nationaal Bieronderzoek. Available online: https://www.nederlandsebrouwers.nl/biersector/publicaties/nationaal-bieronderzoek/ (accessed on 14 March 2021).
- Anderson, P.; O’Donnell, A.; Kokole, D.; Llopis, E.J.; Kaner, E. Is Buying and Drinking Zero and Low Alcohol Beer a Higher Socio-Economic Phenomenon? Analysis of British Survey Data, 2015–2018 and Household Purchase Data 2015–2020. Int. J. Environ. Res. Public Health 2021, 18, 10347. [Google Scholar] [CrossRef]
- Nicholls, E. “You Can Be a Hybrid When It Comes to Drinking” The Marketing and Consumption of No and Low Alcohol Drinks in the UKIAS Paper. Available online: https://www.ias.org.uk/wp-content/uploads/2022/03/The-Marketing-and-Consumption-of-No-and-Low-Alcohol-Drinks-in-the-UK-March-2022.pdf (accessed on 30 June 2022).
- Staub, C. Consumer Behaviour of Alcoholic Beverages. Available online: https://www.research-collection.ethz.ch/handle/20.500.11850/537809 (accessed on 30 June 2022).
- Mekonnen, M.; Hoekstra, A. The green, blue and grey water footprint of crops and derived crop products. Hydrol. Earth Syst. Sci. Discuss. 2011, 8, 763–809. [Google Scholar] [CrossRef]
- Boulay, A.M.; Lenoir, L. Sub-national regionalisation of the AWARE indicator for water scarcity footprint calculations. Ecol. Indic. 2020, 111, 106017. [Google Scholar] [CrossRef]
- Schestak, I.; Styles, D.; Black, K.; Williams, A.P. Circular Use of Feed By-Products from Alcohol Production Mitigates Water Scarcity. Sustain. Prod. Consum. 2022, 30, 158–170. [Google Scholar] [CrossRef]
- Amienyo, D.; Azapagic, A. Life cycle environmental impacts and costs of beer production and consumption in the UK. Int. J. Life Cycle Assess. 2016, 21, 492–509. [Google Scholar] [CrossRef]
- D’Ammaro, D.; Capri, E.; Valentino, F.; Grillo, S.; Fiorini, E.; Lamastra, L. Benchmarking of carbon footprint data from the Italian wine sector: A comprehensive and extended analysis. Sci. Total Environ. 2021, 779, 146416. [Google Scholar] [CrossRef]
- Sánchez, R.; Paredes, D.A.F.; Laoretani, D.; Villada, Y.; Fuentes, M.; Espinosa, J. On the Conceptual Design of the Hybrid Nanofiltration/Distillation Process in the production of alcohol-free Beers. Sep. Purif. Technol. 2021, 267, 118625. [Google Scholar] [CrossRef]
- Morgan, D.; Styles, D.; Lane, E.T. Thirsty work: Assessing the environmental footprint of craft beer. Sustain. Prod. Consum. 2020, 27, 242–253. [Google Scholar] [CrossRef]
- Hauser, D.; Shellhammer, T.H. An Overview of Sustainability Challenges in Beer Production, and the Carbon Footprint of Hops Production. Tech. Q. 2019, 56. [Google Scholar] [CrossRef]
- AB InBev. 2021 Environmental, Social & Governance Report. Available online: https://www.ab-inbev.com/assets/pdfs/ABINBEV_ESG_2021_Final.pdf (accessed on 30 June 2022).
- Heineken ‘on the Path to Net Zero’. Available online: https://www.theheinekencompany.com/sites/theheinekencompany/files/Downloads/PDF/sustainability%20and%20responsibility/heineken-on-the-path-to-net-zero-2021.pdf (accessed on 30 June 2022).
- Margallo, M.; Aldaco, R.; Barceló, A.; Diban, N.; Ortiz, I.; Irabien, A. Life cycle assessment of technologies for partial dealcoholisation of wines. Sustain. Prod. Consum. 2015, 2, 29–39. [Google Scholar] [CrossRef]
- Maesano, G.; Milani, M.; Nicolosi, E.; D’Amico, M.; Chinnici, G. A Network Analysis for Environmental Assessment in Wine Supply Chain. Agronomy 2022, 12, 211. [Google Scholar] [CrossRef]
- Leivas, R.; Laso, J.; Hoehn, D.; Margallo, M.; Fullana-i-Palmer, P.; Aldaco, R. Product vs Corporate Carbon Footprint: A Case Study for the Spirit Drinks Sectors. Chem. Eng. Trans. 2019, 76, 223–228. [Google Scholar] [CrossRef]
- Hallström, E.; Håkansson, N.; Åkesson, A.; Wolk, A.; Sonesson, U. Climate impact of alcohol consumption in Sweden. J. Clean. Prod. 2018, 201, 287–294. [Google Scholar] [CrossRef]
- Marteau, T.M.; Hollands, G.J.; Pechey, R.; Reynolds, J.P.; Jebb, S.A. Analysis: Changing the assortment of available food and drink for leaner, greener diets. BMJ 2022, 377, e069848. [Google Scholar] [CrossRef]
- IPCC. Climate Change 2022. Impacts, Adaptation and Vulnerability. Available online: https://www.ipcc.ch/report/ar6/wg2/ (accessed on 30 June 2022).
- IPCC. Climate Change 2022. Mitigation of Climate Change. Available online: https://www.ipcc.ch/report/ar6/wg3/ (accessed on 30 June 2022).
- Esteras-Saz, J.; de la Iglesia, Ó.; Peña, C.; Escudero, A.; Téllez, C.; Coronas, J. Theoretical and practical approach to the dealcoholization of water-ethanol mixtures and red wine by osmotic distillation. Sep. Purif. Technol. 2021, 270, 118793. [Google Scholar] [CrossRef]
- Santos, J.A.; Yang, C.; Fraga, H.; Malheiro, A.C.; Moutinho-Pereira, J.; Dinis, L.-T.; Correia, C.; Moriondo, M.; Bindi, M.; Leolini, L.; et al. Short-term adaptation of European viticulture to climate change: An overview from the H2020 Clim4Vitis action. IVES Tech. Rev. Vine Wine 2021. [Google Scholar] [CrossRef]
- Santos, J.A.; Yang, C.; Fraga, H.; Malheiro, A.C.; Moutinho-Pereira, J.; Dinis, L.-T.; Correia, C.; Moriondo, M.; Bindi, M.; Leolini, L.; et al. Long-term adaptation of European viticulture to climate change: An overview from the H2020 Clim4Vitis action. IVES Tech. Rev. Vine Wine 2021. [Google Scholar] [CrossRef]
- Ministry for Primary Industies. Lighter Wines; Ministry for Primary Industies: Wellington, New Zealand, 2017. Available online: https://www.mpi.govt.nz/funding-rural-support/primary-growth-partnerships-pgps/current-pgpprogrammes/lighter-wines/ (accessed on 30 June 2022).
- Available online: https://ec.europa.eu/info/funding-tenders/opportunities/portal/screen/opportunities/horizon-results-platform/29316;resultId=29316 (accessed on 30 June 2022).
- Available online: https://cordis.europa.eu/project/id/774234 (accessed on 30 June 2022).
- Duchêne, E.; Huard, F.; Dumas, V.; Schneider, C.; Merdinoglu, D. The challenge of adapting grapevine varieties to climate change. Clim. Res. 2010, 41, 193–204. [Google Scholar] [CrossRef] [Green Version]
- van Leeuwen, C.; Darriet, P. The Impact of Climate Change on Viticulture and Wine Quality. J. Wine Econ. 2016, 11, 150–167. [Google Scholar] [CrossRef]
- Corfe, S. Pour Decisions. Available online: https://www.smf.co.uk/publications/pour-decisions/ (accessed on 30 June 2022).
- Blecher, E. Taxes on tobacco, alcohol and sugar sweetened beverages: Linkages and lessons learned. Soc. Sci. Med. 2015, 136–137, 175–179. [Google Scholar] [CrossRef]
- Available online: https://www.talkingretail.com/products-news/alcohol/carlsberg-uk-reduces-skol-abv-to-2-8-22-09-2011/ (accessed on 30 June 2022).
- Llopis, E.J.; O’Donnell, A.; Anderson, P. Impact of price promotion, price, and minimum unit price on household purchases of low and no alcohol beers and ciders: Descriptive analyses and interrupted time series analysis of purchase data from 70, 303 British households, 2015–2018 and first half of 2020. Soc. Sci. Med. 2021, 270, 113690. [Google Scholar] [CrossRef]
- Anderson, P.; Kokole, D.; Llopis, E.J. Impact of minimum unit pricing on shifting purchases from higher to lower-strength beers in Scotland: Controlled interrupted time series analyses, 2015–2020. Drug Alcohol Rev. 2021, 41, 646–656. [Google Scholar] [CrossRef]
- O’Donnell, A.; Anderson, P.; Jane-Llopis, E.; Manthey, J.; Kaner, E.; Rehm, J. Immediate impact of minimum unit pricing on alcohol purchases in Scotland: Controlled interrupted time series analysis for 2015–2018. Br. Med. J. 2019, 366, l5274. [Google Scholar] [CrossRef]
- Anderson, P.; O’Donnell, A.; Kaner, E.; Jané-Llopis, E.; Manthey, J.; Rehm, J. Impact of minimum unit pricing on alcohol purchases in Scotland and Wales: Controlled interrupted time series analyses. Lancet Public Health 2021, 6, e557–e565. [Google Scholar] [CrossRef]
- Rehm, J.; O’Donnell, A.; Kaner, E.; Jané Llopis, E.; Manthey, J.; Anderson, P. Differential impact of minimum unit pricing on alcohol consumption between Scottish men and women: Controlled interrupted time series analysis. BMJ Open 2022, 12, e054161. [Google Scholar] [CrossRef]
- Stockwell, T.; Zhao, J.; Giesbrecht, N.; Macdonald, S.; Thomas, G.; Wettlaufer, A. The raising of minimum alcohol prices in Saskatchewan, Canada: Impacts on consumption and implications for public health. Am. J. Public Health 2012, 102, e103–e110. [Google Scholar] [CrossRef]
- Blackwell, A.K.M.; De-Loyde, K.; Hollands, G.J.; Morris, R.W.; Brocklebank, L.A.; Maynard, O.M.; Fletcher, P.C.; Marteau, T.M.; Munafò, M.R. The impact on selection of non-alcoholic vs alcoholic drink availability: An online experiment. BMC Public Health 2020, 20, 526. [Google Scholar] [CrossRef]
- Clarke, N.; Blackwell, A.K.M.; Ferrar, J.; De-Loyde, K.; Pilling, M.A.; Munafò, M.R.; Marteau, T.M.; Hollands, G.J. Impact on alcohol selection and purchasing of increasing the proportion of non-alcoholic versus alcoholic drinks: Randomised controlled trial. medRxiv 2022. Available online: https://www.medrxiv.org/content/10.1101/2022.03.04.22271898v1.article-info (accessed on 30 June 2022).
- Shemilt, I.; Hendry, V.; Marteau, T.M. What do we know about the effects of exposure to ‘Low alcohol’ and equivalent product labelling on the amounts of alcohol, food and tobacco people select and consume? A systematic review? BMC Public Health 2017, 17, 29. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Vasiljevic, M.; Frings, D.; Pilling, M.; Marteau, T.M. Do alcohol product labels stating lower-strength verbal description, percentage alcohol-by-volume, or their combination affect wine consumption? A bar laboratory adaptive randomised controlled trial. Addiction 2021, 116, 2339–2347. [Google Scholar] [CrossRef] [PubMed]
- Jané Llopis, E.; O’Donnell, A.; Anderson, P.; Kaner, E. Are lower-strength beers gateways to higher-strength beers? Time series analyses of household purchases from 64,280 British households, 2015–2018. Alcohol Alcohol. 2022, 57, 520–528. [Google Scholar] [CrossRef]
- Kandel, D. Stages in adolescent involvement in drug use. Science 1975, 190, 912–914. [Google Scholar] [CrossRef]
- Vanyukov, M.M.; Tarter, R.E.; Kirillova, G.P.; Kirisci, L.; Reynolds, M.D.; Kreek, M.J.; Conway, K.P.; Maher, B.S.; Iacono, W.G.; Bierut, L.; et al. Common liability to addiction and “gateway hypothesis”: Theoretical, empirical and evolutionary perspective. Drug Alcohol Depend. 2012, 123 (Suppl. 1), S3–S17. [Google Scholar] [CrossRef]
- Kinjo, A.; Imamoto, A.; Ikeda, M.; Itani, O.; Ohida, T.; Kaneita, Y.; Kanda, H.; Tanihata, T.; Higuchi, S.; Osaki, Y. The Association Between Alcohol-Flavoured Non-Alcoholic Beverages and Alcohol Use in Japanese Adolescents. Alcohol Alcohol. 2017, 52, 351–357. [Google Scholar] [CrossRef]
- Filbey, F.M.; Claus, E.; Audette, A.R.; Niculescu, M.; Banich, M.T.; Tanabe, J.; Du, Y.P.; Hutchison, K.E. Exposure to the taste of alcohol elicits activation of the mesocorticolimbic neurocircuitry. Neuropsychopharmacology 2008, 33, 1391–1401. [Google Scholar] [CrossRef]
- Sebold, M.; Müller, C.A.; Garbusow, M.; Charlet, K.; Heinz, A. Neurobiology of Alcohol Dependence. In Textbook of Addiction Treatment; El-Guebaly, N., Carrà, G., Galanter, M., Baldacchino, A.M., Eds.; Springer: Cham, Switzerland, 2021. [Google Scholar] [CrossRef]
- Shields, C.N.; Gremel, C.M. Review of Orbitofrontal Cortex in Alcohol Dependence: A Disrupted Cognitive Map? Alcohol. Clin. Exp. Res. 2020, 44, 1952–1964. [Google Scholar] [CrossRef]
- Braun, T.D.; Kunicki, Z.J.; Blevins, C.E.; Stein, M.D.; Marsh, E.; Feltus, S.; Miranda, R., Jr.; Thomas, J.G.; Abrantes, A.M. Prospective Associations between Attitudes toward Sweet Foods, Sugar Consumption, and Cravings for Alcohol and Sweets in Early Recovery from Alcohol Use Disorders. Alcohol Treat. Q. 2021, 39, 269–281. [Google Scholar] [CrossRef] [PubMed]
- de Wit, G.A.; Everaars, B.; Bilderbeek, B.; Visscher, K.; Hendrikx, R.; Voogt, C. Reclame Voor en Gebruik van Alcoholvrije Dranken, RIVM-Briefrapport 2021-0069. 2021. Available online: https://www.rivm.nl/publicaties/reclame-voor-en-gebruik-van-alcoholvrije-dranken (accessed on 14 March 2021).
- Barker, A.B.; Bal, J.; Murray, R.L. A Content Analysis and Population Exposure Estimate of Guinness Branded Alcohol Marketing during the 2019 Guinness Six Nations. Alcohol Alcohol. 2021, 56, 617–620. [Google Scholar] [CrossRef] [PubMed]
- Murray, R.; Breton, M.O.; Britton, J.; Cranwell, J.; Grant-Braham, B. Carlsberg alibi marketing in the UEFA euro 2016 football finals: Implications of Probably inappropriate alcohol advertising. BMC Public Health 2018, 18, 553. [Google Scholar] [CrossRef] [PubMed]
- Act on the Sale of Alcoholic Beverages (Alcohol Act). Available online: https://www.helsedirektoratet.no/tema/alkohol/Act%20on%20the%20Sale%20of%20Alcoholic%20Beverages,%20etc.%20(Alco-hol%20Act)%20-%20Unofficial%20version.pdf/_/attachment/inline/cf610698-d822-4e67-9c64-803a2939971f:1aa4342cb2f3893cbb5b436fa29e18d25a161b7b/Act%20on%20the%20Sale%20of%20Alcoholic%20Beverages,%20etc.%20(Alcohol%20Act)%20-%20Unofficial%20version.pdf#:~:text=The%20purpose%20of%20regulating%20the,the%20consumption%20of%20alcoholic%20beverages (accessed on 30 June 2022).
- Jernigan, D.; Ross, C.S. The alcohol marketing landscape: Alcohol industry size, structure, strategies, and public health responses. J. Stud. Alcohol Drugs 2020, (Suppl. 19), 13–25. [Google Scholar] [CrossRef]
- Courtney, A.L.; Casey, B.J.; Rapuano, K.M. A neurobiological model of alcohol marketing effects on underage drinking. J. Stud. Alcohol Drugs 2020, (Suppl. 19), 68–80. [Google Scholar] [CrossRef]
- Finan, L.J.; Lipperman-Kreda, S.; Grube, J.W.; Balassone, A.; Kaner, E. Alcohol marketing and adolescent and young adult alcohol use behaviors: A systematic review of cross-sectional studies. J. Stud. Alcohol Drugs 2020, (Suppl. 19), 42–56. [Google Scholar] [CrossRef]
- Sargent, J.D.; Babor, T.F. The Relationship between Exposure to Alcohol Marketing and Underage Drinking Is Causal. J. Stud. Alcohol Drugs Suppl. 2020, (Suppl. 19), 113–124. [Google Scholar] [CrossRef]
- Henehan, E.R.; Joannes, A.E.; Greaney, L.; Knoll, S.; Wong, Q.W.; Ross, C.S. Youth cognitive responses to alcohol promotional messaging: A systematic review. J. Stud. Alcohol Drugs 2020, (Suppl. 19), 26–41. [Google Scholar] [CrossRef]
- Jackson, K.M.; Bartholow, B.D. Psychological processes underlying effects of alcohol marketing on youth drinking. J. Stud. Alcohol Drugs 2020, (Suppl. 19), 81–96. [Google Scholar] [CrossRef]
- Noel, J.K.; Sammartino, C.J.; Rosenthal, S.R. Exposure to digital alcohol marketing and alcohol use: A systematic review. J. Stud. Alcohol Drugs 2020, (Suppl. 19), 57–67. [Google Scholar] [CrossRef]
- Saffer, H. Evaluating econometric studies of alcohol advertising. J. Stud. Alcohol Drugs 2020, (Suppl. 19), 106–122. [Google Scholar] [CrossRef]
- Sargent, J.D.; Cukier, S.; Babor, T.F. Alcohol marketing and youth drinking: Is there a causal relationship, and why does it matter? J. Stud. Alcohol Drugs 2020, (Suppl. 19), 5–12. [Google Scholar] [CrossRef]
- Padon, A.A.; Rimal, R.N.; Siegel, M.; DeJong, W.; Naimi, T.S.; JernFigan, D.H. Alcohol brand use of youth-appealing advertising and consumption by youth and adults. J. Public Health Res. 2018, 7, 1269. [Google Scholar] [CrossRef] [PubMed]
- Mialon, M.; McCambridge, J. Alcohol industry corporate social responsibility initiatives and harmful drinking: A systematic review? Eur. J. Public Health 2018, 28, 664–673. [Google Scholar] [CrossRef] [PubMed]
- McCambridge, J.; Mialon, M.; Hawkins, B. Alcohol industry involvement in policymaking: A systematic review? Addiction 2018, 113, 1571–1584. [Google Scholar] [CrossRef] [PubMed]
- McCambridge, J.; Mialon, M. Alcohol industry involvement in science: A systematic review of the perspectives of the alcohol research community? Drug Alcohol Rev. 2018, 37, 565–579. [Google Scholar] [CrossRef] [PubMed]
- Babor, T.F. Alcohol research and the alcoholic beverage industry: Issues, concerns and conflicts of interest? Addiction 2009, 104, 34–47. [Google Scholar] [CrossRef]
- Dwyer, R.; Room, R.; O’Brien, P.; Cook, M.; Gleeson, D. Alcohol Industry Submissions to the WHO 2020 Consultation on the Development of an Alcohol Action Plan: A Content and Thematic Analysis; Centre for Alcohol Policy Research, La Trobe University: Melbourne, Australia, 2022. [Google Scholar]
- Scott, C.; Hawkins, B.; Knai, C. Food and beverage product reformulation as a corporate political strategy? Soc. Sci. Med. 2017, 172, 37–45. [Google Scholar] [CrossRef]
- Chikritzhs, T.; Stockwell, T.; Pascal, R. The impact of the Northern Territory’s Living with Alcohol program, 1992–2002: Revisiting the evaluation. Addiction 2005, 100, 1625–1636. [Google Scholar] [CrossRef]
- Pellegrini, C.; Martelli, A.; Antonioli, L.; Fornai, M.; Blandizzi, C.; Calderone, V. NLRP3 inflammasome in cardiovascular diseases: Pathophysiological and pharmacological implications? Med. Res. Rev. 2021, 41, 1890–1926. [Google Scholar] [CrossRef]
- Muñoz-Garcia, N.; Escate, R.; Badimon, L.; Padro, T. Moderate Beer Intake Downregulates Inflammasome Pathway Gene Expression in Human Macrophages. Biology 2021, 10, 1159. [Google Scholar] [CrossRef] [PubMed]
- Daimiel, L.; Micó, V.; Díez-Ricote, L.; Ruiz-Valderrey, P.; Istas, G.; Rodríguez-Mateos, A.; Ordovás, J.M. Alcoholic and Non-Alcoholic Beer Modulate Plasma and Macrophage microRNAs Differently in a Pilot Intervention in Humans with Cardiovascular Risk. Nutrients 2021, 13, 69. [Google Scholar] [CrossRef] [PubMed]
- Colpaert, R.M.W.; Calore, M. Epigenetics and microRNAs in cardiovascular diseases. Genomics 2021, 113, 540–551. [Google Scholar] [CrossRef]
- Naqvi, A.R.; Sarwat, M. MicroRNAs and immunity. Semin. Cell Dev. Biol. 2022, 124, 1–2. [Google Scholar] [CrossRef]
- Chiva-Blanch, G.; Magraner, E.; Condines, X.; Valderas-Martínez, P.; Roth, I.; Arranz, S.; Casas, R.; Navarro, M.; Hervas, A.; Sisó, A.; et al. Effects of alcohol and polyphenols from beer on atherosclerotic biomarkers in high cardiovascular risk men: A randomized feeding trial. Nutr. Metab. Cardiovasc. Dis. 2015, 25, 36–45. [Google Scholar] [CrossRef]
- Olšovská, J.; Štěrba, K.; Vrzal, T.; Čejka, P. Nutritional composition and energy value of different types of beer and cider? Kvasny Prumysl 2019, 65, 32–37. [Google Scholar] [CrossRef]
- Singh, S.; Kaur, I.; Kariyat, R. The Multifunctional Roles of Polyphenols in Plant-Herbivore Interactions. Int. J. Mol. Sci. 2021, 22, 1442. [Google Scholar] [CrossRef]
- Swallah, M.S.; Sun, H.; Affoh, R.; Fu, H.; Yu, H. Antioxidant Potential Overviews of Secondary Metabolites (Polyphenols) in Fruits. Int. J. Food Sci. 2020, 2020, 9081686. [Google Scholar] [CrossRef]
- Fraga, C.G.; Croft, K.D.; Kennedy, D.O.; Tomás-Barberán, F.A. The effects of polyphenols and other bioactives on human health. Food Funct. 2019, 10, 514–528. [Google Scholar] [CrossRef]
- Cory, H.; Passarelli, S.; Szeto, J.; Tamez, M.; Mattei, J. The Role of Polyphenols in Human Health and Food Systems: A Mini-Review. Front. Nutr. 2018, 5, 87. [Google Scholar] [CrossRef]
- Schutte, R.; Smith, L.; Wannamethee, G. Alcohol—The myth of cardiovascular protection. Clin. Nutr. 2022, 41, 348–355. [Google Scholar] [CrossRef] [PubMed]
- Roth, I.; Casas, R.; Medina-Remón, A.; Lamuela-Raventós, R.M.; Estruch, R. Consumption of aged white wine modulates cardiovascular risk factors via circulating endothelial progenitor cells and inflammatory biomarkers. Clin. Nutr. 2019, 38, 1036–1044. [Google Scholar] [CrossRef]
- Roth, I.; Casas, R.; Ribó-Coll, M.; Estruch, R. Consumption of Aged White Wine under a Veil of Flor Reduces Blood Pressure-Increasing Plasma Nitric Oxide in Men at High Cardiovascular Risk. Nutrients 2019, 11, 1266. [Google Scholar] [CrossRef]
- Anderson, P. The Impact of Alcoholic Beverages on Human Health. Nutrients 2021, 13, 4417. [Google Scholar] [CrossRef] [PubMed]
- Andrés-Iglesias, C.; Blanco, C.A.; Montero, O. Sugar, Hop α-Acid, and Amino Acid Contents Contribute to the Differential Profile Between Nonalcoholic and Alcoholic Beers. Food Anal. Methods 2019, 12, 59–68. [Google Scholar] [CrossRef]
- Bauwens, J.; Van Opstaele, F.; Eggermont, L.; Weiland, F.; Jaskula-Goiris, B.; De Rouck, G.; De Brabanter, J.; Aerts, G.; De Cooman, L. Comprehensive Analytical and Sensory Profiling of Non-alcoholic Beers and Their Pale Lager Beer Counterparts. J. Inst. Brew. 2021, 127, 385–405. [Google Scholar] [CrossRef]
- Oneta, C.M.; Simanowski, U.A.; Martinez, M.; Allali-Hassani, A.; Parés, X.; Homann, N.; Conradt, C.; Waldherr, R.; Fiehn, W.; Coutelle, C.; et al. First pass metabolism of ethanol is strikingly influenced by the speed of gastric emptying. Gut 1998, 43, 612–619. [Google Scholar] [CrossRef]
- Lee, S.L.; Chau, G.Y.; Yao, C.T.; Wu, C.W.; Yin, S.J. Functional assessment of human alcohol dehydrogenase family in ethanol metabolism: Significance of first-pass metabolism. Alcohol Clin. Exp. Res. 2006, 30, 1132–1142. [Google Scholar] [CrossRef]
- Cederbaum, A.I. Alcohol metabolism. Clin. Liver Dis. 2012, 16, 667–685. [Google Scholar] [CrossRef] [PubMed]
- Lachenmeier, D.W.; Kanteres, F.; Rehm, J. Epidemiology-based risk assessment using the benchmark dose/margin of exposure approach: The example of ethanol and liver cirrhosis. Int. J. Epidemiol. 2011, 40, 210–218. [Google Scholar] [CrossRef]
- He, F.J.; MacGregor, G.A. Role of salt intake in prevention of cardiovascular disease: Controversies and challenges. Nat. Rev. Cardiol. 2018, 15, 371–377. [Google Scholar] [CrossRef] [PubMed]
- Santos, J.A.; Tekle, D.; Rosewarne, E.; Flexner, N.; Cobb, L.; Al-Jawaldeh, A.; Kim, W.J.; Breda, J.; Whiting, S.; Campbell, N.; et al. A Systematic Review of Salt Reduction Initiatives Around the World: A Midterm Evaluation of Progress Towards the 2025 Global Non-Communicable Diseases Salt Reduction Target. Adv. Nutr. Int. Rev. J. 2021, 12, 1768–1780. [Google Scholar] [CrossRef] [PubMed]
- World Health Organisation. Global Information System on Alcohol and Health (GISAH). Available online: http://apps.who.int/gho/data/node.gisah.A1191?lang=en&showonly=GISAH (accessed on 30 June 2022).
- Sperkova, K.; Anderson, P.; Jane-Llopis, E. Alcohol policy measures are an ignored catalyst for achievement of the Sustainable Development Goals. PLoS ONE 2022, 17, e0267010. [Google Scholar] [CrossRef]
- Rombouts, M.; van Dorsselaer, S.; Scheffers-van Schayck, T.; Tuithof, M.; Kleinjan, M.; Monshouwer, K. Youth and Risky Behavior 2019: Key Data from the Sentinel Station Survey for Schoolchildren; Trimbos Institute: Utrecht, The Netherlands, 2020; Available online: https://www.rijksoverheid.nl/documenten/rapporten/2020/07/01/jeugd-en-riskant-gedrag-2019 (accessed on 14 March 2021).
- Caluzzi, G.; Livingston, M.; Holmes, J.; MacLean, S.; Lubman, D.; Dietze, P.; Vashishtha, R.; Herring, R.; Pennay, A. Declining drinking among adolescents: Are we seeing a denormalisation of drinking and a normalisation of non-drinking? Addiction 2022, 117, 1204–1212. [Google Scholar] [CrossRef]
- Smeets, P.A.M.; de Graaf, C. Brain Responses to Anticipation and Consumption of Beer with and without Alcohol. Chem. Senses 2019, 44, 51–60. [Google Scholar] [CrossRef]
- Kilian, C.; Rovira, P.; Neufeld, M.; Ferreira-Borges, C.; Rumgay, H.; Soerjomataram, I.; Rehm, J. Modelling the impact of increased alcohol taxation on alcohol-attributable cancers in the WHO European Region. Lancet Reg. Health Eur. 2021, 11, 100225. [Google Scholar] [CrossRef]
- Salanță, L.C.; Coldea, T.E.; Ignat, M.V.; Pop, C.R.; Tofană, M.; Mudura, E.; Borșa, A.; Pasqualone, A.; Anjos, O.; Zhao, H. Functionality of Special Beer Processes and Potential Health Benefits. Processes 2020, 8, 1613. [Google Scholar] [CrossRef]
- Kozłowski, R.; Dziedziński, M.; Stachowiak, B.; Kobus-Cisowska, J. Non- and low-alcoholic beer—Popularity and manufacturing techniques? Acta Sci. Pol. Technol. Aliment. 2021, 20, 347–357. [Google Scholar] [CrossRef]
- Merinas-Amo, T.; Del Río Celestino, M.; Font, R.; Alonso- Moraga, Á. Safety and Protective Activities of Manufactured Alcohol-Free Beers. Processes 2022, 10, 331. [Google Scholar] [CrossRef]
- Keșa, A.L.; Pop, C.R.; Mudura, E.; Salanță, L.C.; Pasqualone, A.; Dărab, C.; Burja-Udrea, C.; Zhao, H.; Coldea, T.E. Strategies to Improve the Potential Functionality of Fruit-Based Fermented Beverages? Plants 2021, 10, 2263. [Google Scholar] [CrossRef]
- Sam, F.E.; Ma, T.-Z.; Salifu, R.; Wang, J.; Jiang, Y.-M.; Zhang, B.; Han, S.-Y. Techniques for Dealcoholization of Wines: Their Impact on Wine Phenolic Composition, Volatile Composition, and Sensory Characteristics. Foods 2021, 10, 2498. [Google Scholar] [CrossRef] [PubMed]
- Mellor, D.D.; Hanna-Khalil, B.; Carson, R. A Review of the Potential Health Benefits of Low Alcohol and Alcohol-Free Beer: Effects of Ingredients and Craft Brewing Processes on Potentially Bioactive Metabolites. Beverages 2020, 6, 25. [Google Scholar] [CrossRef]
- Spaggiari, G.; Cignarelli, A.; Sansone, A.; Baldi, M.; Santi, D. To beer or not to beer: A metaanalysis of the effects of beer consumption on cardiovascular health. PLoS ONE 2020, 15, e0233619. [Google Scholar] [CrossRef]
- Trius-Soler, M.; Marhuenda-Muñoz, M.; Laveriano-Santos, E.P.; Martínez-Huélamo, M.; Sasot, G.; Storniolo, C.E.; Estruch, R.; Lamuela-Raventós, R.M.; Tresserra-Rimbau, A. Moderate Consumption of Beer (with and without Ethanol) and Menopausal Symptoms: Results from a Parallel Clinical Trial in Postmenopausal Women. Nutrients 2021, 13, 2278. [Google Scholar] [CrossRef]
- Petrine, J.C.P.; Del Bianco-Borges, B. The influence of phytoestrogens on different physiological and pathological processes: An overview. Phytother. Res. 2021, 35, 180–197. [Google Scholar] [CrossRef]
- Ide, N.; Ajenikoko, A.; Steele, L.; Cohn, J.; Curtis, C.J.; Frieden, T.R.; Cobb, L.K. Priority Actions to Advance Population Sodium Reduction. Nutrients 2020, 12, 2543. [Google Scholar] [CrossRef] [PubMed]
- Gressier, M.; Sassi, F.; Frost, G. Contribution of reformulation, product renewal, and changes in consumer behavior to the reduction of salt intakes in the UK population between 2008/2009 and 2016/2017. Am. J. Clin. Nutr. 2021, 114, 1092–1099. [Google Scholar] [CrossRef]
- Torre, S.B.D.; Moullet, C.; Chaparro, C.J. Impact of Measures Aiming to Reduce Sugars Intake in the General Population and Their Implementation in Europe: A Scoping Review. Int. J. Public Health 2022, 66, 1604108. [Google Scholar] [CrossRef]
- Kirkpatrick, S.I.; Raffoul, A.; Maynard, M.; Lee, K.M.; Stapleton, J. Gaps in the Evidence on Population Interventions to Reduce Consumption of Sugars: A Review of Reviews. Nutrients 2018, 10, 1036. [Google Scholar] [CrossRef]
- Hashem, K.M.; He, F.J.; MacGregor, G.A. Effects of product reformulation on sugar intake and health–A systematic review and meta-analysis. Nutr. Rev. 2019, 77, 181–196. [Google Scholar] [CrossRef]
- Belc, N.; Smeu, I.; Macri, A.; Vallauri, D.; Flynn, K. Reformulating foods to meet current scientific knowledge about salt, sugar and fats? Trends Food Sci. Technol. 2018, 84, 25–28. [Google Scholar] [CrossRef]
- Gressier, M.; Swinburn, B.; Frost, G.; Segal, A.; Sassi, F. What is the impact of food reformulation on individuals’ behaviour, nutrient intakes and health status? A systematic review of empirical evidence? Obes. Rev. 2020, 22, e13139. [Google Scholar] [CrossRef] [PubMed]
- Gressier, M.; Sassi, F.; Frost, G. Healthy Foods and Healthy Diets. How Government Policies Can Steer Food Reformulation. Nutrients 2020, 12, 1992. [Google Scholar] [CrossRef] [PubMed]
- Inman, T. Is Alcohol Food? Br. Med. J. 1862, 2, 351–353. [Google Scholar] [CrossRef]
- English, L.K.; Ard, J.D.; Bailey, R.L.L.; Bates, M.; Bazzano, L.A.; Boushey, C.J.; Brown, C.; Butera, G.; Callahan, E.H.; de Jesus, J.; et al. Evaluation of dietary patterns and all-cause mortality: A systematic review. JAMA Netw Open 2021, 4, e2122277. [Google Scholar] [CrossRef]
- Oussalah, A.; Levy, J.; Berthezène, C.; Alpers, D.H.; Guéant, J.L. Health outcomes associated with vegetarian diets: An umbrella review of systematic reviews and meta-analyses. Clin. Nutr. 2020, 39, 3283–3307. [Google Scholar] [CrossRef]
- Kwasny, T.; Dobernig, K.; Riefler, P. Towards reduced meat consumption: A systematic literature review of intervention effectiveness, 2001–2019. Appetite 2022, 168, 105739. [Google Scholar] [CrossRef]
- World Resources Institute. Playbook for Guiding Diners toward Plant-Rich Dishes in Food Service. Available online: https://www.wri.org/research/playbook-guiding-diners-toward-plant-rich-dishes-food-service (accessed on 30 June 2022).
- Anderson, P.; Jané-Llopis, E.; Hasan, O.S.M.; Rehm, J. Changing Collective Social Norms in Favour of Reduced Harmful Use of Alcohol: A Review of Reviews. Alcohol Alcohol. 2018, 53, 326–332. [Google Scholar] [CrossRef]
- Marteau, T.M.; Rutter, H.; Marmot, M. Changing behaviour: An essential component of tackling health inequalities. BMJ 2021, 372, n332. [Google Scholar] [CrossRef]
- Corsinovi, P. Consumer Taxes on Alcohol: Is the Wine Sector a Niche Within the Alcoholic Beverages? Ital. Econ. J. 2021, 7, 341–348. [Google Scholar] [CrossRef]
- Anderson, K. Consumer taxes on alcohol: An international comparison over time. J. Wine Econ. 2020, 15, 42–70. [Google Scholar] [CrossRef]
Framework Category | Question | Key Findings | Evidence Limitation | Associated References |
---|---|---|---|---|
Implementation | What is the extent of the production of lower strength alcohol products? | Production is low with large differences between European countries, largely restricted to beer, but increasing. | Routine reported production restricted to beer. | [27,28,29] |
To what extent are consumers buying and drinking lower strength alcohol products? | Purchase and consumption is low with large differences between European countries, largely restricted to beer, but increasing. | Very little routine data collected; household purchase data restricted to two countries (Great Britain and Spain). | [28,30,31] | |
What are the currently implemented policies relevant for lower strength alcohol products? | Despite some intentions, little policy is set at country or European levels that might favour substitution. On the other hand, many existing policies set at country and European levels disfavour substitution. | What policy set at European level to favour substitution has not been evaluated. | [32,33,34,35,36,37,38,39,40,41,42,43] | |
Context | Who buys and drinks lower strength alcohol products and why? | In general, it seems, at least for beer, that younger and those with higher incomes are more likely to buy and drink no- and low-alcohol products, in about two-fifths of cases report doing so to drink less alcohol. | Mostly based on grey, rather than academic literature. | [27,44,45,46,47,48,49,50] |
What are factors influencing the production of lower strength products? | Increased production costs of de-alcoholization offset by increased revenues. Global heating leads to higher strength wines. Life cycle assessments suggest increased global warming potential of de-alcoholization likely to be marginal, as most global warming potential comes from cultivation and packaging. | Insufficient information available on life cycle assessments of de-alcoholization. | [51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77] | |
What policies should be set that can gain health benefits from lower strength alcohol products, whilst avoiding the negative consequences? | Modelling studies suggest that taxes that rise with alcohol by volume (ABV) steeper at the lowest ABV levels would favour substitution. Empirical analyses of household purchase data find that the introduction of minimum unit price favours substitution. Experimental studies suggest that increased availability and improved labelling of no- and low-alcohol products would favour substitution. | The findings from minimum unit price are robust, but overall, evidence base for policy limited. | [78,79,80,81,82,83,84,85,86,87,88,89,90] | |
Mechanisms of impact | Do consumers substitute higher strength with lower strength products? | Household purchase data from Great Britain and Spain indicate substitution for purchases of beers and wines. | Scientific publications limited to household purchase data from two jurisdictions. | [27,31,46,91] |
Does buying and drinking lower strength products act as a gateway to buying and drinking higher strength products? | Available evidence from youth surveys and household purchase data suggests not. Impact of no- and low- alcohol products for those with a diagnosis of “alcohol dependence” unknown. | Youth survey data limited to one grey-literature Dutch study and one academic Japanese study. Publications based on household purchase data limited to Great Britain and Spain. | [31,91,92,93,94,95,96,97,98] | |
Is there additional and alibi marketing due to introduction of lower strength alcohol products? | Additional and alibi marketing appears to exist; despite considerable evidence of the impact of advertising on youth consumption, no specific studies of impact of no- and low-alcohol products on consumption behaviour. At least for beer, brand loyalty seems to favour switching from higher to lower strength products, but not the other way round. | No specific evidence available on impact of no-alcohol advertising on youth behaviour. Publications based on household purchase data limited to Great Britain | [49,91,99,100,101,102,103,104,105,106,107,108,109,110,111,112] | |
Is there additional policy interference because of focus on lower strength alcohol products? | Whilst alcohol producers do interfere with the policy environment, no documented studies describe interference related to no- and low-alcohol products. | No documented studies that describe specific interference related to no- and low-alcohol products. | [113,114,115,116,117] | |
Outcome | Does substitution reduce alcohol consumption? | Household purchase data from Great Britain and Span demonstrate that substitution is associated with decreased purchases of grams of alcohol overall, in relation to beers, wines and spirits. | Publications based on household purchase data limited to Great Britain and Spain. | [29,30,31] |
Does substitution improve health? | Empirical analyses of health outcomes subsequent to substitution have not been identified; however, as substitution results in fewer grams of alcohol at least purchased, and reduced consumption results in health gains, substitution likely to improve health. Small randomised-controlled trials have demonstrated that no-alcohol beers and wines either had improved or same potentially beneficial health outcomes as regular strength beers and wines from other components in the absence of the toxic effects of alcohol; however, the extent to which these potential benefits compare to the health benefits of reduced alcohol consumption has not been studied, although likely to be marginal. In general, no-alcohol beers have lower energetic value but higher sugar content than alcoholic beers.Alcohol content of no-alcohol products likely to be of no measurable health risk. | No empirical analyses available. | [118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140] |
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Anderson, P.; Kokole, D.; Jané Llopis, E.; Burton, R.; Lachenmeier, D.W. Lower Strength Alcohol Products—A Realist Review-Based Road Map for European Policy Making. Nutrients 2022, 14, 3779. https://doi.org/10.3390/nu14183779
Anderson P, Kokole D, Jané Llopis E, Burton R, Lachenmeier DW. Lower Strength Alcohol Products—A Realist Review-Based Road Map for European Policy Making. Nutrients. 2022; 14(18):3779. https://doi.org/10.3390/nu14183779
Chicago/Turabian StyleAnderson, Peter, Daša Kokole, Eva Jané Llopis, Robyn Burton, and Dirk W. Lachenmeier. 2022. "Lower Strength Alcohol Products—A Realist Review-Based Road Map for European Policy Making" Nutrients 14, no. 18: 3779. https://doi.org/10.3390/nu14183779
APA StyleAnderson, P., Kokole, D., Jané Llopis, E., Burton, R., & Lachenmeier, D. W. (2022). Lower Strength Alcohol Products—A Realist Review-Based Road Map for European Policy Making. Nutrients, 14(18), 3779. https://doi.org/10.3390/nu14183779